Tag Archives: addiction

For ADHD drugs it's dependence vs abuse, not addiction vs dependence

Amy and I had a strong debate today about the difference between addiction and dependence. Both of us were using different explanations, so we resorted to the official definitions in the DSM-IV, the American Psychiatric Associations big book of disorders and definitions.

As you will read below their is no mention of addiction in the manual. They purposely excluded that term in favor of more descriptive ones. Which means that addiction is now classified as dependence or abuse.

Substance Dependence

The essential feature of Substance Dependence is a cluster of cognitive, behavioral, and physiological, symptoms indicating that the individual continues use of the substance despite significant substance-related problems.

There is a pattern of self-administration that can result in tolerance, withdrawal, and compulsive drug-taking behavior. A diagnosis of Substance Dependence can be applied to every class of substances except caffeine.

Substance Abuse

The essential feature of Substance Abuse is a maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to the repeated use of substances.

Unlike the criteria for Substance Dependence, the criteria for Substance Abuse do not include tolerance, withdrawal, or a pattern of compulsive use and instead include only the harmful consequences of repeated use.

Addiction vs Dependence/Abuse

The DSM views abuse and dependency as a continuum, meaning addiction is not, in their eyes, an on-or-off proposition, but a disorder with degrees of affliction. The distinction is important when compared to 12-step programs, which preach that one is either addicted or not, and if you are, you are powerless over such addiction.

via Powerless No Longer

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For ADHD drugs it’s dependence vs abuse, not addiction vs dependence

Amy and I had a strong debate today about the difference between addiction and dependence. Both of us were using different explanations, so we resorted to the official definitions in the DSM-IV, the American Psychiatric Associations big book of disorders and definitions.

As you will read below their is no mention of addiction in the manual. They purposely excluded that term in favor of more descriptive ones. Which means that addiction is now classified as dependence or abuse.

Substance Dependence

The essential feature of Substance Dependence is a cluster of cognitive, behavioral, and physiological, symptoms indicating that the individual continues use of the substance despite significant substance-related problems.

There is a pattern of self-administration that can result in tolerance, withdrawal, and compulsive drug-taking behavior. A diagnosis of Substance Dependence can be applied to every class of substances except caffeine.

Substance Abuse

The essential feature of Substance Abuse is a maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to the repeated use of substances.

Unlike the criteria for Substance Dependence, the criteria for Substance Abuse do not include tolerance, withdrawal, or a pattern of compulsive use and instead include only the harmful consequences of repeated use.

Addiction vs Dependence/Abuse

The DSM views abuse and dependency as a continuum, meaning addiction is not, in their eyes, an on-or-off proposition, but a disorder with degrees of affliction. The distinction is important when compared to 12-step programs, which preach that one is either addicted or not, and if you are, you are powerless over such addiction.

via Powerless No Longer

Continue reading

Got Adderall? The Great D.E.A. Versus F.D.A. Duke-Out

Maybe you heard about The Great Adderall Shortage of 2011 that impacted “millions of children and adults” who rely on the pills to help stay focused and calm? Maybe you haven’t.

In terms of national crises, like joblessness and obesity, I wouldn’t rank it at the top of the list (although a country producing drug-addicted college graduates should be a concern), and yet it’s become very much a crisis for people dependent, or more accurately, addicted to the drug.

At the heart of the shortage is an ever-growing struggle between the F.D.A., who recently included several attention-deficit disorder drugs on its official shortages list, and the D.E.A. who is trying to minimize abuse by people, many of them college students who use the medication as a study aid.

It’s become so much of a problem in academia that colleges like Duke University have issued new policies to address misuse, qualifying it as cheating:

The unauthorized use of prescription medication to enhance academic performance has been added to the definition of Cheating.

The D.E.A., who authorizes a certain amount the core ingredient of Adderall — mixed amphetamine salts — to be released to drugmakers each year based on what the agency considers to be the country’s legitimate medical need, finds itself embroiled in a growing epidemic.

In 2010, more than 18 million prescriptions were written for Adderall, up 13.4 percent from 2009, according to IMS Health, which tracks prescription data.

As someone who has been on, and gotten off Adderall, I’m steadfastly in the D.E.A.’s corner. It is a highly addictive drug with serious side effects, especially after continued use, and can create more problems than it solves. Go to any ADHD forum/message board and read the testimonials of folks dealing with its impacts.

Can I Be Your Trusted Friend?

The following is an un-edited letter I sent to a friend, similar to the one on Processed Foods. It represents a set of personal beliefs developed through experience, failure, and success. While I believe much of this to be dead-on there is much to disagree with. I welcome an open debate:)

—-

For thousands of years humans lived easily without ADD and ADHD “diseases.” It’s not that these symptoms didn’t exist rather it is that our lifestyles have changed. There is an increasing focus of daily life on controlled seated conditions for an ever increasing amount of people. This is a relatively new environment for humans and our culture has not yet learned how to function in it.

There are basic skills one can learn to alleviate the symptoms of ADD and ADHD, that if not taught by adulthood lead to destructive habits. The foundation of these skills is helping the individual to become self aware. Creating a sense of when things are normal and when they are not. Once that recognition can happen a series of coping mechanisms can be put into play. More on that later, but first some more background.

ADD as a problem (and not a disease) has been studied and worked on for decades in the field of education. The Montessori school system has developed a method of teaching that they believe is superior to public education, while also helping to alleviate the problems of ADHD. Of course their schools are only as effective as the parents allow it to be. Parents are a major problem in education because they often endured harsh conditions without learning these skills and expect their children to endure as well, though for much longer (college and graduate school).

The real battle in our public schools is not over testing but over new teaching styles. To improve the quality of our education we need to teach our students better. School testing is only a measure of how effective these new styles are. The most effective styles to date ironically focus on alleviating the root causes of ADHD, things like group work, outdoor activities, large projects with structured tasks, etc.

Understanding this history in American education helps explain some key issues involved with ADHD, namely culture, environment, and adults. For a child we can help to control all three and make the process of dealing with ADHD easier. For an adult the process is like hardened cement, only making progress through blasting old concrete and recasting new pieces.

Back to the original “cure.” The first step is to become self aware. Doing this often requires a trusted friend. One who can tell the person that they are exhibiting the behavior. It is hard on both parties to develop this routine since ADHD manifests itself in many ways, through boredom, anxiety, depression, over-excitement, and most importantly the individual is unaware of their own behavior. With practice and experience this becomes easily explained and noticed.

The second step is to develop a range of support tactics to employ when suffering an attack. This involves the individual being self aware of the issue and then selecting the right tactic, or trying several until one helps. The tactics can be anything from taking a long walk to reading a magazine. They are entirely situational and often require a fair amount of practice. They act like a bridge where one side is normal and the other side is normal. ADHD acts like the river in the middle always ready to sidetrack and take you away through panic, anxiety, or whatever. Having a bridge allows one to cope during the attack, let it subside, and then safely arrive at normal again.

ADHD is not the scourge of the modern world. It is a problem in our society that only a few truly understand, the rest suffer from it. To fix it requires a simple yet focused set of skills applied over time with another trusted individual. For children this trusted individual is often the parents or a teacher. For an adult it is a boyfriend, friend, or coworker. For those without any of these people it is a drug addiction.

Twitter is way better than anything else

I love you Twitter. You are the new hotness. I don’t care what other people say about you. I don’t even care if my business partner thinks that time apart from you is beneficial. This is your time, your moment.

Heck, even US News loves you. You recently made the list of “50 ways to improve your life”. And, in so doing you were called: “increasingly popular and addictive”. (yep, found via twitter thru @tigerninety and written by @papertrailblog).

Now even the celebrities love you. Your newest friends are @jimmyfallon, @tinafey, @mchammer, @greggrunberg, @al_gore, @the_real_shaq, @lancearmstrong, @breagrant, @johncleese, and my personal favorite @hodgman.

If that wasn’t enough, all of your competitors are just not cutting it. Each one goes for your jugular only to settle for some small piece of the pie. You are even rumored to be on your second round of funding in a deep recession. That is because you are way better than anything else.

This is partly due to being the first on the block (which I am not even sure you were). It’s also partly due to your simplicity. But, and I mean but, I attribute your success to a little discussed fact.

You are the first great success of the mobile web. Your predecessor is the Blackberry. The mobile device that brought mobile email to painstaking heights of popularity and necessity (/wave prez obama). Your successor may come around, but until it does, you are king of the mobile web hill.

Now that you are in that moment, all of your detractors are singing death and destruction mightily. Clinging to anything that will allow them to avoid your wiles. You are not the fad, silly tool they think you are. You are not just a mobile facebook or a place for “extraverts to lord over the intraverts”. Nor are you just a place for “social media experts” to bask in their own glory.

What you really are is harder to say. As the first true child of the mobile web you are changing the game as you play it. Your question of “what are you doing right now?” is not even important anymore. None of your strongest users even answer that question anymore. They have moved onto taking the richness of their lives and posting that instead. They post photos, links, jokes, pithy thoughts, dinner plans, current events, conversations, and they create accounts for their animals (<3 @fuzzles).

That would be impressive all by its lonesome. It would be extremely impressive for a “website”. But one cannot talk about your glory without talking about your inextricable connection with mobility. As @stoweboyd once told me, mobility is the future of the web. We are no longer sitting at our “command center” with our clunky desktop. We are on the go and joining that “world consciousness” that my roommate surmises is the next evolution in our spirituality.

This mobility is really the hardest to explain. It is, well, umm, just amazing. It is incredible. Ok, I’m obvsiously struggling to define this, so instead let me tell you a story. A weird story, really, but it resonates with me and stirs up fondness for you:

There I was walking down the street and right as I took a step into the street, a car comes flying by. It was going fast, I mean real fast for the city, like 60-70mph. Which is death defying speeds in Washington DC, where blocks are tiny and going 40 feels like ur flying. In an instant I step back before 3 cop cars come flying down after this perp. What an amazing moment. Witness a car chase. Nearly die. Contemplate life and being lucky. What do I do with this moment?

In the “old world” I would call a close friend and bore them with this simple story. Or, I could go home and write a journal entry exploring my life and how lucky I am to be alive. Yeah, been there done that.

In the world of Twitter, I share the moment. I instantly share the moment with hundreds of friends. I feel relieved, I feel a community, and I don’t feel alone in a panicked moment. I get multiple replies instantly too.

Strange, I know. But, in that moment I realized what the mobile web meant to me. It was an instant connection. A tie with the world at large that never existed before. An ability to stay connected anytime with everyone important in my life.

Let’s utilize some academia for this point. Have you heard of the “aggregate phenomenon”?

The Japanese sociologist Mizuko Ito first noticed it with mobile phones: lovers who were working in different cities would send text messages back and forth all night — tiny updates like “enjoying a glass of wine now” or “watching TV while lying on the couch.” They were doing it partly because talking for hours on mobile phones isn’t very comfortable (or affordable). But they also discovered that the little Ping-Ponging messages felt even more intimate than a phone call. [1]
That’s right: “felt even more intimate”. These silly little messages bring me closer to my friends/family.
“It’s an aggregate phenomenon,” Marc Davis, a chief scientist at Yahoo and former professor of information science at the University of California at Berkeley, told me. “No message is the single-most-important message. It’s sort of like when you’re sitting with someone and you look over and they smile at you. You’re sitting here reading the paper, and you’re doing your side-by-side thing, and you just sort of let people know you’re aware of them.” [1]

Let’s just break the space/time continuum and let me connect with my family back in California and my friends in cities all over the world.

Finally, the capstone for this love story. Time. It’s so valuable. I just don’t have enough of it for everyone in my life. Twitter, without you there would be no way for me to maintain my Dunbar number (a theory that humans can only maintain a max of 150 social relationships) let alone the 500+ people I connect with regularly.

But, with you I can and do. I develop bonds with over 500+ people on a consistent basis. I do it with little or no effort. I even save time. Which allows me to turn around and spend that time on more quality things in my life. Like pretty girls or writing inane posts on this site.

Written by the @robotchampion